ReviewFrontiers in cardiovascular medicine2022
Minor perturbations of thyroid homeostasis and major cardiovascular endpoints-Physiological mechanisms and clinical evidence.
Review in Frontiers in cardiovascular medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- The Role of Hormones in Hidradenitis Suppurativa: A Systematic Review.International journal of molecular sciences · 2022Pooled it
- Screening for atrial fibrillation according to serum thyroid-stimulating hormone: an opportunity for refinement?Annals of translational medicine · 2026Article
- Thyrotoxicosis in MCT8 deficiency.The Journal of clinical endocrinology and metabolism · 2026Review
- Thyroid hormone sensitivity, insulin resistance and visceral fat area as determinants of prevalent coronary heart disease in euthyroid patients with type 2 diabetes.Frontiers in endocrinology · 2026Article
- Thyrotropin Directly Affects Cardiac Electrophysiology and Is Associated With AF Prevalence.Circulation. Arrhythmia and electrophysiology · 2025Article
- Long-Term Effects of Stress During Adolescence on the Sex-Dependent Responses of Thyroid Axis and Target Tissues to Exercise in Male and Female Wistar Rats.International journal of molecular sciences · 2025Article
- Research status of subclinical hypothyroidism promoting the development and progression of cardiovascular diseases.Frontiers in cardiovascular medicine · 2025Review
- The genomic bases of atrial fibrillation in an Ecuadorian patient: a case report.Frontiers in cardiovascular medicine · 2025Article
- Sex differences in 10-year cardiovascular risk of patients with type 2 diabetes mellitus and subclinical hypothyroidism: a cross-sectional study.Frontiers in endocrinology · 2025Observational
- Biological determinants of blood-based biomarker levels in Alzheimer's disease: role of nutrition, inflammation, and metabolic factors.Frontiers in aging neuroscience · 2025Review
- Effect of thyroid stimulating hormone on the prognosis of coronary heart disease.Frontiers in endocrinology · 2025Article
- [Arrhythmias in thyroid dysfunction].Herzschrittmachertherapie & Elektrophysiologie · 2024Review
- Deciphering the roles of triiodothyronine (T3) and thyroid-stimulating hormone (TSH) on cardiac electrical remodeling in clinical and experimental hypothyroidism.Journal of physiology and biochemistry · 2024Review
- The Thyroid-cardiac Axis: Thyroid Function, Cardiac Rhythmology, and Sudden Cardiac Death.Endocrine, metabolic & immune disorders drug targets · 2024Review
- Stress-Mediated Abnormalities in Regional Myocardial Wall Motion in Young Women with a History of Psychological Trauma.Journal of clinical medicine · 2023Article
- Normal thyroid stimulating hormone is associated with all-cause mortality in patients with acute myocardial infarction after percutaneous coronary intervention.European journal of medical research · 2023Article
- Thyroid Dysfunction in Periand Postmenopausal Women-Cumulative Risks.Deutsches Arzteblatt international · 2023Review
- The role of supporting and disruptive mechanisms of FT3 homeostasis in regulating the hypothalamic-pituitary-thyroid axis.Therapeutic advances in endocrinology and metabolism · 2023Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
It is well established that thyroid dysfunction is linked to an increased risk of cardiovascular morbidity and mortality. The pleiotropic action of thyroid hormones strongly impacts the cardiovascular system and affects both the generation of the normal heart rhythm and arrhythmia. A meta-analysis of published evidence suggests a positive association of FT4 concentration with major adverse cardiovascular end points (MACE), but this association only partially extends to TSH. The risk for cardiovascular death is increased in both subclinical hypothyroidism and subclinical thyrotoxicosis. Several published studies found associations of TSH and FT4 concentrations, respectively, with major cardiovascular endpoints. Both reduced and elevated TSH concentrations predict the cardiovascular risk, and this association extends to TSH gradients within the reference range. Likewise, increased FT4 concentrations, but high-normal FT4 within its reference range as well, herald a poor outcome. These observations translate to a monotonic and sensitive effect of FT4 and a U-shaped relationship between TSH and cardiovascular risk. Up to now, the pathophysiological mechanism of this complex pattern of association is poorly understood. Integrating the available evidence suggests a dual etiology of elevated FT4 concentration, comprising both ensuing primary hypothyroidism and a raised set point of thyroid function, e. g. in the context of psychiatric disease, chronic stress and type 2 allostatic load. Addressing the association between thyroid homeostasis and cardiovascular diseases from a systems perspective could pave the way to new directions of research and a more personalized approach to the treatment of patients with cardiovascular risk.
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